In vivo pressure profiles of thigh-length graduated compression stockings

Abstract

Thigh-length graduated compression stockings may be most effective in bedridden patients. Knee-length stockings may be more suitable for the prevention of deep vein thrombosis in ambulant patients.

Graded compression stockings in elective orthopaedic surgery

“…The ideal pressure gradient of 18.0, 14.0 and 8.0 mmHg ± 20% 13 was noted only twice throughout the study (0.7% of measurements). Quite often the stockings produced low readings under the elasticated band around the calf.…”

“…[15][16][17] Above-knee stockings are more uncomfortable for the patient and may produce band-like constrictions at the knee during flexion. 13 They are more expensive than below-knee stockings and do not appear to be any more effective in preventing DVT. Their use in patients undergoing arthroplasty should be discouraged.…”

“…A reverse gradient was defined as a pressure of greater than 4 mmHg generated at a more proximal part of the stocking. 9,13 For the reasons given in Table I, In designing the study we anticipated two groups of patients, one with appropriate pressure profiles and one without. The initial results after 44 patients indicated a sixfold difference in the rates of DVT (4.7% v 30.4%).…”

“…In a previous study these had been shown to give the best pressure profiles. 9,13 The pressures generated by the GCS were measured in mmHg by air cells beneath the stockings, connected to an Oxford Pressure Monitor MK II (Talley Medical Group Ltd, Romsey, UK). Measurements were taken from 1 cm above and anterior to the medial malleolus, the mid-calf half way between the medial femoral epicondyle and the medial malleolus, and under the elasticated band at the top of the stocking at the popliteal fossa.…”

“…Anti-Em stockings proved to be slightly more reliable than Tx, while TED stockings were clearly inferior. 13 This disparity between the gradients claimed to be produced by stockings and those observed in vivo led us to investigate whether stockings produce the correct pressure profiles in patients having joint replacements and to determine the effect of adverse pressure gradients on the subsequent formation of DVT.…”